Clinical Evaluation of Laser Application Versus Conventional Surgery in Functional Crown Lengthening

Abstract

Functional Clinical crown lengthening(FCL) is a periodontal resective procedure aimed at partial removal of supporting periodontal tissues to increase exposure of coronal tooth structure. FCL indicated for functional issues to aid in retention forms for restoration fabrication, by facilitating tooth preparation, margin placement and impression taking. FCL involves various techniques, including gingivectomy or gingivoplasty, apically positioned flap procedure, which may include osseous resection and forced tooth eruption. Laser-tissue ablation results in adequate exposure of tooth structure with minimal or no bleeding, allowing the clinician to place a restoration immediately. Aim: The aim of this study is to compare between functional crown lengthening (gingivectomy without bone removal) using diode laser versus conventional surgical technique (using scalpel) in the degree of postoperative pain expressed by Visual Analog Scale(VAS) and patient's satisfaction scale and post operative edema. Materials and method: Fourteen teeth were selected for the study but unfortunately, only 12 teeth were found during study duration (two teeth dropped one in each group) resulted in 6 teeth in each group. Patients were 5 females (41.7%) and 7 males (58.3%) with age ranging from 18- 40 years, who referred for functional crown lengthening from both conservative and fixed prosthodontic departments at Khartoum dental teaching hospital and Omdurman military dental teaching hospital. They were divided into two groups: case group and control group. Case group consists of 7 teeth (one case was dropped) were treated using laser technique (diode laser) with 810nm and 980nm wave length in continuous mode(CW). And control group: consist of 7 teeth who were treated with conventional scalpel technique (one case was dropped). Results: Postoperative pain and patient satisfaction ranges of each patient were recorded using a VAS after 3 hours (same day), 3 days and 7 days after crown lengthening procedure for both groups. Clinical assessment of post operative swelling was recorded after 3 days. The obtained results indicated that patients treated with the diode laser had less postoperative pain (same day) with significant result (P value =0.017) and they were more satisfied and required fewer analgesics compared to patients treated with the conventional scalpel technique with significant difference (P value=0.024). No participant suffers from edema at both groups.Conclusion: From this project, it can be concluded that the application of diode laser appears to be more predictable and comprise the state-of-the-art instrumentation, and effective alternative procedure for the treatment of functionally short clinical crowns